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The natural evolution of heart disease before birth: Growth of the cardiac chambers and great arteries in prenatally diagnosed congenital heart disease (CHD)
Department, The
clinical
afaa ael. YPt *
It, Cairo resentation of tetralogy to the
a
of Fallot varies in relation sites right sided obstruction. The Doppler diastolic tricuspid flow with anglographically only infundibular ventricular OUQf 1OW tract obstruction (g~o~p-~~. he rest (groupadditional stenosis had B), (pulmonary valvular and/o catheter hemodynamic R higher value in groupThe ratio of the late to velocities (W/E) an areas, were 0.77 2 0.15 and 0.51 f 0.13, in ere significan .29 2 0.27,
IN SITU HYBRIDIZATION OF HWMAN ATHEROSCLEROTIC MJLTEHIAL FROM CORONARY AHTERIES AND SAPHENOIJS VEIN GRAFT BIOPSIED WITH AN ATHEHECTOMY CATHETER. Safian, Isner, Isr,:)
, Lawrence Weir, Michael Simons, Robert D. Donald S. Bairn and Jef:rey M. Marianne Kearney, St.Elizabeth's Hospital, Boston, MA.,and Beth Hospital, Boston@ MA.
1) to determine whether The purpose of this study was: atbeitisclerotic (ATH) mater-al f rem human corcndry arteries (CA) and saphenous vein grafts iSVb1 obtained percutaneously using a mechanical atherectomy device (Atherocath) could be satisfactorily analyzed at the level of gene tran;cription; and 2) to assess in different types of ATH lesions the expression of an isoform of a human nonmuscle myosin heavy chain (NMMHCB) mHNA, which may have a role in cytokinesis. Twentyfour f#fn frozen sections were prepared from three fresh stenotic lesions removed by directed aer.erectomy in three patients with symptomatic coronary artery disease. Two lesions (16 sections) were primary coronary stencses; one lesion (8 sections) was a SVG restencsis lesion. All twenty-four sections were examined by :n situ hybridization (ISH) using a RNA antisense (A; probe specific for NMMHC-B mBNA. The specificity of the usina a hybridization was controlled by noncomplementary sense (5) probe. All sections of the restenotic lesion showed strong hybridization to the A probe with clustering of 220 grains/cell nucleus in 2 90% of tota? cells on 100x mag fields selected at random and analyzed using a semi-quantitative scoring system. showed minimal In contrast, primary plaques hybridization (<20% of cells hybridized, at an intensity level of <20 grains/cell nucleus). Conclusicns: 1) The Atherocath is a satisfactory tool for obtaining ATH material from CA and SVG that can be processed for 2) tnese preliminary analysis of gene transcription: findings suggest that activation of NMMHC-B may pla:r a role in the development of restenosis lesions.
THE NA L EVOLUTION OF HEART DISEASE BEFORE BIRTH: GROWTH THF CARDIAC CHAHBERS AND GREAT ARTERIES IN PRENATALLY DIAGNOSED CONGENITAL HEART DISEASE (CHD). Lisa K. Hornberger, David J. Sahn, Kathryn Reed. Univ. Calif San Diego. CA; Univ. Arizona, Tucson, AZ. To 4ssess cardiac chamber and great artery (GA) growth in feeuses with CHD. we reviewed 66 echocardiograms from studfed fetuses wieh prenatally diagnosed s gestation). (Follow-up = 5 to 17 wks; mean fetuses with a hypoplastic RV (2) or LV (G) had some growth of the hypoplastic structures, which nonetheless remained ~30% of the size of the unaffected ventricle and its GA, but in 3 others (2 HLV, 1 HRV) the hypoplaseic structures failed to grow at all. Three fetuses with dysplastic TV and tricuspid insufficiency (1 initially with a normal, symmetric I( chamber view) developed massive RV size with an RV to LV diameter ratio of 2/l. In 3 fetuses with PA obstruction (1 D-transposition, 2 double outlet RV [DORV]) and in 2 of ehe fetuses with TV dysplasia who later developed PA atresia, the PA grew but remained smaller than the AO. The PA did not grow at all in 3 fetuses with tetralogy of Fallot cr in 2 others with single venericle and sub PS. All structures grew normally in 3 fetuses with ventricular septal defects. Narrowing of the ascending A0 and branch PAS was not apparent at 21 wks but obseruction progressed from 17-X wks in a Leeus with autosomal dominant supravalve AS. In 1 fetus with truncus srteriosus and trunpropor ehe RV and LV grew equally a 6x31 stenosis, RV, 1 eion to the eruncus. Finally in 2 fetuses id not single ventricle) with a small AO, the AQ grow and coarctetion anatomy became apparent in the The variable patterns of flow or functhird trimester. tion related growth of the cardiac chambers and GAS in fetuses with CHD necessitate serial study for determining prognosis and planning postnatal q snegement.
clinical
afaa ael. YPt *
It, Cairo resentation of tetralogy to the
a
of Fallot varies in relation sites right sided obstruction. The Doppler diastolic tricuspid flow with anglographically only infundibular ventricular OUQf 1OW tract obstruction (g~o~p-~~. he rest (groupadditional stenosis had B), (pulmonary valvular and/o catheter hemodynamic R higher value in groupThe ratio of the late to velocities (W/E) an areas, were 0.77 2 0.15 and 0.51 f 0.13, in ere significan .29 2 0.27,
IN SITU HYBRIDIZATION OF HWMAN ATHEROSCLEROTIC MJLTEHIAL FROM CORONARY AHTERIES AND SAPHENOIJS VEIN GRAFT BIOPSIED WITH AN ATHEHECTOMY CATHETER. Safian, Isner, Isr,:)
, Lawrence Weir, Michael Simons, Robert D. Donald S. Bairn and Jef:rey M. Marianne Kearney, St.Elizabeth's Hospital, Boston, MA.,and Beth Hospital, Boston@ MA.
1) to determine whether The purpose of this study was: atbeitisclerotic (ATH) mater-al f rem human corcndry arteries (CA) and saphenous vein grafts iSVb1 obtained percutaneously using a mechanical atherectomy device (Atherocath) could be satisfactorily analyzed at the level of gene tran;cription; and 2) to assess in different types of ATH lesions the expression of an isoform of a human nonmuscle myosin heavy chain (NMMHCB) mHNA, which may have a role in cytokinesis. Twentyfour f#fn frozen sections were prepared from three fresh stenotic lesions removed by directed aer.erectomy in three patients with symptomatic coronary artery disease. Two lesions (16 sections) were primary coronary stencses; one lesion (8 sections) was a SVG restencsis lesion. All twenty-four sections were examined by :n situ hybridization (ISH) using a RNA antisense (A; probe specific for NMMHC-B mBNA. The specificity of the usina a hybridization was controlled by noncomplementary sense (5) probe. All sections of the restenotic lesion showed strong hybridization to the A probe with clustering of 220 grains/cell nucleus in 2 90% of tota? cells on 100x mag fields selected at random and analyzed using a semi-quantitative scoring system. showed minimal In contrast, primary plaques hybridization (<20% of cells hybridized, at an intensity level of <20 grains/cell nucleus). Conclusicns: 1) The Atherocath is a satisfactory tool for obtaining ATH material from CA and SVG that can be processed for 2) tnese preliminary analysis of gene transcription: findings suggest that activation of NMMHC-B may pla:r a role in the development of restenosis lesions.
THE NA L EVOLUTION OF HEART DISEASE BEFORE BIRTH: GROWTH THF CARDIAC CHAHBERS AND GREAT ARTERIES IN PRENATALLY DIAGNOSED CONGENITAL HEART DISEASE (CHD). Lisa K. Hornberger, David J. Sahn, Kathryn Reed. Univ. Calif San Diego. CA; Univ. Arizona, Tucson, AZ. To 4ssess cardiac chamber and great artery (GA) growth in feeuses with CHD. we reviewed 66 echocardiograms from studfed fetuses wieh prenatally diagnosed s gestation). (Follow-up = 5 to 17 wks; mean fetuses with a hypoplastic RV (2) or LV (G) had some growth of the hypoplastic structures, which nonetheless remained ~30% of the size of the unaffected ventricle and its GA, but in 3 others (2 HLV, 1 HRV) the hypoplaseic structures failed to grow at all. Three fetuses with dysplastic TV and tricuspid insufficiency (1 initially with a normal, symmetric I( chamber view) developed massive RV size with an RV to LV diameter ratio of 2/l. In 3 fetuses with PA obstruction (1 D-transposition, 2 double outlet RV [DORV]) and in 2 of ehe fetuses with TV dysplasia who later developed PA atresia, the PA grew but remained smaller than the AO. The PA did not grow at all in 3 fetuses with tetralogy of Fallot cr in 2 others with single venericle and sub PS. All structures grew normally in 3 fetuses with ventricular septal defects. Narrowing of the ascending A0 and branch PAS was not apparent at 21 wks but obseruction progressed from 17-X wks in a Leeus with autosomal dominant supravalve AS. In 1 fetus with truncus srteriosus and trunpropor ehe RV and LV grew equally a 6x31 stenosis, RV, 1 eion to the eruncus. Finally in 2 fetuses id not single ventricle) with a small AO, the AQ grow and coarctetion anatomy became apparent in the The variable patterns of flow or functhird trimester. tion related growth of the cardiac chambers and GAS in fetuses with CHD necessitate serial study for determining prognosis and planning postnatal q snegement.